If you’ve recently had unprotected sex and know you do not want (or are not prepared) to have a baby, you need emergency contraception — quickly.
What Is Emergency Contraception?
If taken as soon as possible after unprotected sex, emergency contraception (EC) can be very effective in the case of a birth control fail, sexual assault or rape, or any other situation where you think you might be pregnant and don’t want to be.
Emergency contraception can help you prevent pregnancy. It comes in several forms:
- A progestin (levonorgestrel) pill, also known by the leading brand name Plan B One-Step
- A pill that contains ulipristal acetate, also known by the brand name Ella.
- Higher than usual doses of combination oral contraceptive pills that have both estrogen and progestin
- The copper IUD, which once inserted into the uterus within 120 hours of unprotected sex, makes it hard for sperm to fertilize an egg
When the United States Supreme Court voted to overturn the Roe v. Wade court decision in June 2022, abortion access became an issue to be decided state by state. As a result, in many states, abortions either became illegal immediately or are soon expected to be against the law.
There are concerns that lawmakers in certain states may try to ban emergency contraception as well. Although emergency contraception does not terminate a pregnancy — defined as implantation of an embryo in the uterine lining — and is generally considered a different concept than abortion, some still lump them together and believe all should be forbidden.
Which Emergency Contraception Method Is Right for You?
EC Is Backup, Not Primary, Birth Control
Remember, it’s crucial to find a reliable and consistent form of birth control to minimize the potential of an unplanned pregnancy. “You should not rely on EC pills as a long-term birth control method,” says Pari Ghodsi, MD, an obstetrician-gynecologist in Los Angeles and spokesperson for the nonprofit group Power to Decide, a campaign to prevent unplanned pregnancy. “They are a backup method, not a first-line birth control method.”
The 4 Different Types of Emergency Contraception
1. The Progestin Pill for Emergency Contraception
The progestin pill is a single pill that should be taken as soon as possible — within 72 hours of unprotected sex — and the sooner you take it, the better it works, according to the Plan B One-Step website.
The pill contains the hormone levonorgestrel, which is a progestin found in birth control pills and other forms of hormonal contraception that stops or delays ovulation to prevent pregnancy, says Dr. Ghodsi. Progestin is a synthetic version of progesterone, a natural hormone produced by a woman’s ovaries that plays a key role in pregnancy.
Progestin side effects aren’t very common, but your next period may come earlier or later than expected, and be heavier, lighter, or more spotty, notes Planned Parenthood. You may get an upset stomach, feel lightheaded or dizzy, or have tender breasts for a short period of time. If you vomit within two hours of taking the pill, it will not be effective and you’ll need to take it again.
How to Get the Progestin Pill: No Prescription Needed
Progestin pills are all available over the counter. “One of the challenges is that people are unaware that you do not need a prescription to obtain emergency contraception,” says Keosha T. Bond, EdD, an adjunct assistant professor of health behavior and community health at New York Medical College in Valhalla. “An individual may be discouraged from requesting emergency contraception because they think you have to be female and show ID. The truth is that you don’t have to be a woman or to have identification.”
The Progestin Pill: What Does It Cost?
On the Plan B website, it costs $49.99 plus tax. Generic versions usually cost about $11 to $45.
If you have health insurance or Medicaid, it’s likely that you can get the progestin pill for free — but you'll need to get a prescription from your doctor or healthcare provider so your health insurance will cover it (even though you don’t need a prescription to buy these types of pills over the counter).
You may also be able to get the morning-after pill for free or low cost from a Planned Parenthood health center, your local health department, or another family planning clinic.
The Progestin Pill: Where Can You Find It?
Progestin pills are available in the family planning aisle of many major pharmacy chains. In cases where it’s kept locked up or behind the counter, a pharmacist “should be able to provide it for you, but you may come across some pharmacists who may try to prevent you from getting it, because a lot of people are very judgmental,” says Dr. Bond. “They see it as an abortion pill, but it’s not. It prevents ovulation.”
2. Ulipristal (Ella) for Emergency Contraception
Like with progestin, you just take one pill. “When taken as directed, ulipristal is more effective in preventing pregnancy than progestin-only or combined emergency contraception pills,” Ghodsi says.
Ulipristal works better than other EC pills for people who weigh 165 lbs or more. But if you weigh 195 pounds or more, ulipristal may not be as effective.
Like with progestin, after you take ulipristal, your next period may come earlier or later than expected, and be heavier, lighter, or more spotty, notes Planned Parenthood. It’s not common, but you may get an upset stomach. If you vomit within two hours of taking ulipristal, it won’t be effective and you’ll need to take it again.
Where to Find It: Ulipristal Requires a Prescription
You can also get a prescription for ulipristal online ($105) and have it shipped to you with next-day delivery. Or visit your local Planned Parenthood or another family planning or health clinic.
Depending on which state you live in, you may be able to get a prescription for ulipristal directly from your pharmacist.
Ulipristal usually costs about $50 at a pharmacy or drugstore, according to Planned Parenthood, but it might be free if you have health insurance or Medicaid.
You may also be able to get ulipristal for free or low cost from a Planned Parenthood health center, your local health department, or another family planning clinic.
3. Combined Birth Control Pills for Emergency Contraception
Known as the Yuzpe method, it’s not the preferred method of EC, because it causes more side effects and is less effective than other methods. It also must be done under the supervision of a physician. (The number of pills you would take depends on the brand of birth control that you have.)
Nausea and vomiting are common with high doses of birth control pills, notes the Cleveland Clinic.
RELATED: What Is the Yuzpe Method of Emergency Contraception?
Combined Birth Control Pills: Where Can You Find Them?
This may be a good option if you have a prescription already and easy access to a supply. But “do not try to do this on your own,” says Ghodsi. “You need to know the specific amount to take.” Talk to a reproductive healthcare provider or a pharmacist about how many pills to take if you are already on this kind of birth control method and you have it on hand, because “the number of pills needed to use as emergency contraception differs for each brand of pill,” she says.
4. Copper IUD (Paragard) for Emergency Contraception
The Paragard nonhormonal IUD (also called the copper IUD) is a small piece of flexible plastic shaped like a T that has copper wrapped around it.
“The IUD is the most effective EC method in preventing pregnancy,” says Ghodsi. It can then be left in and used for long-term birth control, or removed at any time if you want to try to get pregnant.
Copper IUDs can make your periods heavier and cause cramping, especially in the first three to six months, adds Planned Parenthood. You may also have some cramps when you first get your IUD, but these side effects generally improve over time.
Copper IUD (Paragard): Where to Find It
To use the copper IUD as EC, you will need a healthcare provider to insert the device into your uterus.
Emergency Contraception Recommendations to Consider
If you are overweight or obese, emergency contraceptive pills may be less effective, although they may still work and they’re not harmful. You may want to speak with a physician about whether you should choose a copper IUD instead, because “copper IUDs are effective in women of any weight,” Ghodsi says.
Also, if you choose to use pills for EC, it’s essential to use reliable contraception for the remainder of your cycle, because in many cases, ovulation is simply delayed, not prevented altogether. Therefore, pregnancy could still occur in that cycle if you have unprotected sex after using EC pills.
Embrace the Power of Emergency Contraception
Some people think there’s a stigma associated with using progestin or another form of emergency contraception, as if using it means you’re not being responsible, says Bond. “That’s not the case at all. I don’t think having access to Plan B increases a person’s nonuse of other methods. Condoms break, and Plan B may be your best bet for preventing pregnancy.”
Also, if you’re using a form of EC, “you are being responsible by taking the next step to prevent pregnancy,” adds Bond. “If you are not ready to have a baby, I think it’s a very responsible decision to use emergency contraception.”